Roles of serum L-Arg and IL-4 levels in predicting recurrent ischemic stroke in patients with symptomatic carotid artery stenosis

doi:10.3969/j.issn.1673-8640.2024.07.003

Abstract

Abstract:

Objective To investigate the roles of serum L-arginine （L-Arg） and interleukin（IL）-4 levels in predicting recurrent ischemic stroke （IS） in patients with symptomatic carotid artery stenosis. Methods Totally，196 patients with symptomatic carotid artery stenosis were enrolled from the First Affiliated Hospital of Xi'an Jiaotong University，the First People's Hospital of Xianyang City and Xianyang Hospital of Yan'an University from July 2018 to July 2021. The clinical data of all the patients were collected，and the parameters related to carotid artery stenosis，carotid plaque traits and plaque neovascularization density [baseline intensity，peak intensity and area under curve of time intensity curves（AUCTC）] were examined by Doppler ultrasound. Serum L-Arg and IL-4 levels were determined. All the patients were followed up for 12 months，which were classified into recurrent IS group（35 cases）and non-recurrent IS group（161 cases）. Logistic regression analysis was used to evaluate the risk factors for recurrent IS in patients with symptomatic carotid artery stenosis. Pearson correlation analysis was used to evaluate the correlation among the indicators. Receiver operating characteristic （ROC） curves were used to evaluate the efficacy of serum L-Arg and IL-4 levels in determining recurrent IS in patients with symptomatic carotid artery stenosis. Results The peak intensity，AUCTC and carotid artery stenosis rate in recurrent IS group were higher than those in non-recurrent IS group （P<0.001），and serum L-Arg and IL-4 levels were lower than those in non-recurrent IS group （P<0.05）. Serum L-Arg and IL-4 levels were negatively correlated with peak intensity，AUCTC and carotid artery stenosis rate （P<0.05）. Decreased L-Arg，decreased IL-4，increased peak intensity，increased AUCTC，severe carotid artery stenosis，history of hyperlipidemia and vulnerable plaque were all independent risk factors for recurrent IS in patients with symptomatic carotid artery stenosis （P<0.05）. The areas under curves （AUC） of serum L-Arg and IL-4 were 0.803，0.760 and 0.845 in patients with symptomatic carotid artery stenosis. All the patients were classified into reduced and non-reduced groups according to the optimal cut-off values of serum L-Arg and IL-4. The proportions of vulnerable plaque in L-Arg decreased group and IL-4 decreased group were higher than those in L-Arg non-decreased group and IL-4 non-decreased group （P<0.001）. Conclusions Low levels of serum L-Arg and IL-4 are associated with recurrent IS in patients with symptomatic carotid artery stenosis，which may be used as the predictors of recurrent IS.

Key words: L-arginine, Interleukin-4, Symptomatic carotid artery stenosis, Ischemic stroke, Recurrence

CLC Number:

R446.1

LIU Yi, SU Xiaoming, WANG Yuanyuan, JU Tao. Roles of serum L-Arg and IL-4 levels in predicting recurrent ischemic stroke in patients with symptomatic carotid artery stenosis[J]. Laboratory Medicine, 2024, 39(7): 634-639.

Figures/Tables 9

References 28

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组别	例数	高血压史/ [例（%）]	糖尿病史/ [例（%）]	高血脂史/ [例（%）]	冠心病史/ [例（%）]	吸烟史/ [例（%）]	重度血管狭窄/ [例（%）]	易损斑块/ [例（%）]
未再发组	161	95（59.00）	36（22.36）	25（15.52）	35（21.73）	47（29.19）	54（33.54）	60（37.26）
再发组	35	30（85.71）	13（37.14）	17（48.57）	10（28.57）	14（40.00）	26（74.28）	28（80.00）
χ²值		8.877	3.351	18.645	0.759	1.567	19.759	21.221
P值		0.003	0.067	<0.001	0.384	0.211	<0.001	<0.001

组别	例数	高血压史/ [例（%）]	糖尿病史/ [例（%）]	高血脂史/ [例（%）]	冠心病史/ [例（%）]	吸烟史/ [例（%）]	重度血管狭窄/ [例（%）]	易损斑块/ [例（%）]
未再发组	161	95（59.00）	36（22.36）	25（15.52）	35（21.73）	47（29.19）	54（33.54）	60（37.26）
再发组	35	30（85.71）	13（37.14）	17（48.57）	10（28.57）	14（40.00）	26（74.28）	28（80.00）
χ²值		8.877	3.351	18.645	0.759	1.567	19.759	21.221
P值		0.003	0.067	<0.001	0.384	0.211	<0.001	<0.001

组别	例数	基线强度/dB	峰值强度/dB	AUCTC/（dB·s^﹣1）	颈动脉狭窄率/%
未再发组	161	2.52±0.63	11.82±3.70	422.21±211.00	67.59±9.68
再发组	35	2.59±0.19	22.34±9.16	704.50±285.05	77.52±10.17
t值		0.670	11.046	6.705	5.275
P值		0.504	<0.001	<0.001	<0.001

组别	例数	基线强度/dB	峰值强度/dB	AUCTC/（dB·s^﹣1）	颈动脉狭窄率/%
未再发组	161	2.52±0.63	11.82±3.70	422.21±211.00	67.59±9.68
再发组	35	2.59±0.19	22.34±9.16	704.50±285.05	77.52±10.17
t值		0.670	11.046	6.705	5.275
P值		0.504	<0.001	<0.001	<0.001

组别	例数	L-Arg/ （μmol·L^-1）	IL-4/ （pg·mL^-1）
未再发组	161	63.25±21.71	110.54±30.82
再发组	35	38.95±18.69	76.89±35.09
t值		6.141	5.707
P值		<0.001	<0.001